FIELD: medicine.
SUBSTANCE: invention relates to oncology, surgery. First, in the standing patient's position, preoperative marking is performed, during which the outline of the excised skin is applied, as well as marking lines - median line, line of submammary fold, lines corresponding to upper and lower edges of incisions, as in Fig. 1, a section of intact skin is selected outside projection of breast tumour, which will be a donor dermal flap. Scalpel or dermatome is used to remove the epidermis on the marked skin area, and the flap is separated from the subcutaneous fat. Produced dermal flap is wound with a sterile tissue moistened in 0.9 % NaCl solution. That is followed by a mastectomy with an axillary-subclavicular lymphadenectomy. Expander bed is formed by cutting a lower edge of a greater pectoral muscle from the lateral border to a middle one-third of the sternum, a lower and lateral walls of the expander bed are formed with a dermal flap of the "hammock" type, wherein the lower edge of the dermal flap is anchored to the submammary fold. Tissue expander is installed. Then upper edge of dermal flap is fixed to lower edge of dissected large pectoral muscle, and lateral edges of dermal flap are fixed to serratus muscles and lateral edge of greater pectoral muscle. Separate drainage of tissue expander bed and axillary area is performed. Wound is sutured in layers.
EFFECT: method provides an effective one-stage breast reconstruction in surgical treatment of breast cancer, eliminates a flap rejection reaction, thereby improving engraftment, provides a good elasticity of the flap, considerably reduces the cost of the materials required for the surgical intervention.
1 cl, 2 ex, 7 dwg
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Authors
Dates
2020-11-03—Published
2020-02-17—Filed